Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

When designing or implementing a

glossary-ref
Gloss
tSNOMED
CT
enabled
application
, the first step is to assess the range of services necessary to meet user requirements. The two main categories of services required by applications are glossary-ref
Gloss
tterminology
services
that only interact with the terminology and glossary-ref
Gloss
trecord
services
which apply the terminology to instance data. These services are described in separate sections of this guide

The Terminology Services Guide describes services that access

glossary-ref
Gloss
tSNOMED
CT
reference data. These services are summarized in .

Anchor
_1fd524cb-3be3-414a-8a58-db4e47fbe390__1
_1fd524cb-3be3-414a-8a58-db4e47fbe390__1
Anchor
_1fd524cb-3be3-414a-8a58-db4e47fbe390__6
_1fd524cb-3be3-414a-8a58-db4e47fbe390__6
Figure 2. SNOMED CT Enabled Terminology

Caption figure
SNOMED CT Enabled Terminology services

The Record services guide describes services that apply

glossary-ref
Gloss
tSNOMED
CT
to represent information in a clinical record. These services are summarized in .

Anchor
_1fd524cb-3be3-414a-8a58-db4e47fbe390__9
_1fd524cb-3be3-414a-8a58-db4e47fbe390__9
Anchor
_1fd524cb-3be3-414a-8a58-db4e47fbe390__f
_1fd524cb-3be3-414a-8a58-db4e47fbe390__f
Figure 3. SNOMED CT Enabled Record

Caption figure
SNOMED CT Enabled Record Services

Anchor
_117164b9-a851-41c0-8ba7-ebb9b9b7e984
_117164b9-a851-41c0-8ba7-ebb9b9b7e984
Service architecture

A

glossary-ref
Gloss
tSNOMED
CT
enabled
application
may be completely self-contained, delivering all the required services as part of a single development. Alternatively, service delivery may be modularized so that separately developed reusable modules are used to meet specific sets of requirements.

A distinction can be made between functions that only require interaction with terminology resources (

glossary-ref
Gloss
tterminology
services
) and functions that involve using the terminology as part of an application such as an glossary-ref
Gloss
telectronic
health
record
( glossary-ref
Gloss
trecord
services
).

glossary-ref

Gloss
tTerminology
services
can be generalized, so that they are independent of the way the terminology is used in a particular clinical record application. glossary-ref
Gloss
tTerminology
services
include support for the following types of function.

  • Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__f
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__f
    Read-only functions:
    • Importing and updating a local terminology repository with a glossary-ref
      Gloss
      tSNOMED
      CT
      release
      ;
    • Determining the properties or an identified glossary-ref
      Gloss
      tcomponent
      ;
    • Text or pattern searches for glossary-ref
      Gloss
      tDescriptions
      that include a matching term;
    • Displaying a part of the glossary-ref
      Gloss
      tconcept
      hierarchy;
    • Determining whether a glossary-ref
      Gloss
      tSNOMED
      CT
      concept
      or glossary-ref
      Gloss
      texpression
      is equivalent to or a glossary-ref
      Gloss
      tsubtype
      of another glossary-ref
      Gloss
      tconcept
      or glossary-ref
      Gloss
      texpression
      ;
    • Locating the glossary-ref
      Gloss
      tmap
      from a particular glossary-ref
      Gloss
      tSNOMED
      CT
      concept
      to a code in another scheme or classification.
  • Authoring and maintenance functions:
    Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__5
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__5
    • Enabling the creation and maintenance of core glossary-ref
      Gloss
      tSNOMED
      CT
      components
      to facilitate production of the glossary-ref
      Gloss
      tSNOMED
      CT
      International
      Release
      and glossary-ref
      Gloss
      tExtensions
      to glossary-ref
      Gloss
      tSNOMED
      CT
      ;
    • Enabling the creation and maintenance of derivative such as glossary-ref
      Gloss
      treference
      sets
      to customize and enhance the effective use of glossary-ref
      Gloss
      tSNOMED
      CT
      .

glossary-ref

Gloss
tRecord
services
are intimately related to ways in which information is entered, stored and retrieved by a particular application. Therefore, while these services interact with glossary-ref
Gloss
tterminology
services
they are usually specific to a particular application or to a family of applications with a common underlying record design. glossary-ref
Gloss
tRecord
services
include support for the following types of function:
Anchor
_117164b9-a851-41c0-8ba7-ebb9b9b7e984__9
_117164b9-a851-41c0-8ba7-ebb9b9b7e984__9

  • glossary-ref
    Gloss
    tUser
    interface
    functions that:
    Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__2
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__2
    • Enable entry of information using glossary-ref
      Gloss
      tSNOMED
      CT
      expressions
      where these are relevant;
    • Display of previously entered information, with appropriate rendering of glossary-ref
      Gloss
      tSNOMED
      CT
      expressions
      ;
    • Enable design of protocols that guide data entry to encourage efficient and consistent use of glossary-ref
      Gloss
      tSNOMED
      CT
      ;
    • Enable specification of queries that include appropriate use of glossary-ref
      Gloss
      tSNOMED
      CT
      to meet requirements for selective retrieval.
  • Application server functions that:
    Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__d
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__d
    • Store glossary-ref
      Gloss
      tSNOMED
      CT
      expressions
      as part of the individual record entries (or in other types of instance data);
    • Communicate data including glossary-ref
      Gloss
      tSNOMED
      CT
      expressions
      in ways dictated by standards and local specifications;
    • Apply queries to efficiently, accurately and precisely retrieve information taking account of the data structure of the application and the logical glossary-ref
      Gloss
      tRelationships
      between glossary-ref
      Gloss
      tSNOMED
      CT
      expressions
      .

These two sets of services can be developed and provided separately. This approach allows

glossary-ref
Gloss
trecord
service
to access required glossary-ref
Gloss
tterminology
services
through an glossary-ref
Gloss
tApplication
Programming
Interface
( glossary-ref
Gloss
tAPI
). The guide does not specify an glossary-ref
Gloss
tAPI
but, by making a clear distinction between glossary-ref
Gloss
tterminology
services
and glossary-ref
Gloss
trecord
services
, it identifies the functions that such an interface should support.

Self-contained and modular approaches offer different profiles of advantages, some of which are summarized below.

  • Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__3
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__3
    A modular approach offers the following advantages:
    Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__1
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__1
    • Rapid development of glossary-ref
      Gloss
      tSNOMED
      CT
      related functionality, focused on meeting the requirements of users of a specific software application.
    • Opportunities to choose between different glossary-ref
      Gloss
      tterminology
      servers
      to deliver a cost-effective solution.
    • Simplifies future migration to enhanced or more cost-effective solutions by separately identifying reusable and replaceable modules.
    • Allows several applications used by a single organization to use a single glossary-ref
      Gloss
      tterminology
      server
      . This has several advantages:
      • Reduction of maintenance and support cost associated with installing each release of glossary-ref
        Gloss
        tSNOMED
        CT
        ;
      • Guaranteed alignment of glossary-ref
        Gloss
        tSNOMED
        CT
        releases
        between applications that share the server;
      • Consistency of the glossary-ref
        Gloss
        tuser
        interface
        and technical characteristics of different applications with respect to their access to glossary-ref
        Gloss
        tSNOMED
        CT
        .
  • A fully integrated approach offers the following advantages:
    Anchor
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__a
    _117164b9-a851-41c0-8ba7-ebb9b9b7e984__a
    • Independence of third party development;
    • Customized access to glossary-ref
      Gloss
      tSNOMED
      CT
      tailored to the needs of particular application users.

The approach chosen depends on a careful consideration taking into account the cost and functionality of available

glossary-ref
Gloss
tcomponents
. Commercial and technical concerns about dependence on third-party glossary-ref
Gloss
tcomponents
may be a valid reason for in-house development of all the required services. However, even where all the development is undertaken within a single organization, separation of terminology and glossary-ref
Gloss
trecord
services
into separate glossary-ref
Gloss
tcomponents
may offer a more robust approach, allowing future extensibility and migration at lower cost.